The Failure(s) of Therapy - What needs to change and why?

What needs to change is that the profession needs to ask the question that you have asked: "The Failure(s) of Therapy -- What needs to change and Why?"

That needs to be a topic in professional society meetings and seminars. In professional journal articles. Perhaps a question that government agencies and institutes, etc., need to ask the public at large for input on.

This is a start at things here but I and most of us here have limited influence that I can see. Still, it is a start and we have to start somewhere. And I'm reminded of the psychologist that you posted about from Alberta -- thank goodness for voices out there somewhere.

This is very challenging because of what I said in my previous post: many therapists preach one thing openly and publicly, and practice something else. I participate in many professional forums, conferences etc packed with with mental health clinicians, but most of the time they only talk about the great things, idealistic principles and single-case success stories, not much about limitations, failures, let alone harm. I often try to ask challenging questions to them but they really have a way to twist it or just say therapy is only part of the treatment (so what happens to the client is not entirely their responsibility). Other times, they agree with the criticisms and we have what seems like a great discussion - they they go back to their everyday practices and do more of the same. I think solid research studies about this topic might be a better way, then more public journalists could write popular pieces to promote them - the limitation though is that really solid evidence is hard to gather, especially enough in quantity and quality to make very clear conclusions. I think if someone used the info reported to licensing boards with client complaints, that info might be a good basis, but it is hard to access such information. The whole system is set up to "nicely" conceal its flaws and limitations, especially its harm to clients. There are plenty of more anecdotal stories published online, the kinds we also see posted here on PC sometimes, but a lot of that is dismissed by people who want to believe.

@Xynesthesia2 You bring up many good points, one of which struck me:

Ts should be growth-minded, not fixed-minded.

Another point: Not all of our struggles in adulthood stem from childhood traumas. Some of our psychological, psychosocial, and neurological issues stem from traumas in young adulthood and adulthood. Take, for instance, combat trauma or military sexual trauma. Young adults or adults in military settings may not have had any childhood maltreatment experiences, but their conditions during service as adults may have affected their mental health. Or take resilient persons who have overcome childhood adversities; they may have experienced trauma later on in life (adulthood; for instance, sexual assault, domestic violence, theft, armed robbery, etc.), and it is those traumas that they are dealing with - not childhood ones. Constantly reverting back to childhood traumas negates and minimizes the pain experienced from adulthood traumas.

Another point: Sometimes medical conditions affect mental health. Medical trauma is a real phenomena, and so is grief/loss trauma experienced as an after-effect of medical trauma (job loss, getting on disability and losing incoming, losing active friends because you're less mobile, losing your identity, losing your reputation - especially if a mental illness is added onto a medical trauma, etc.). Being told you have an STD, or being told you have cancer, or being told you have fibromyalgia, or being told you have chronic fatigue syndrome, etc. While some medical issues are not life-threatening in terms of premature death, there are other medical issues that have robbed people of their potentials in life and/or threaten their lives in terms of monetary losses, social capital losses, reputational losses, etc., which are all forms of ecological loss trauma!! Those types of traumas often get overlooked or minimized by Ts who try to get us to focus on the positives, see those things as "negative thinking" or "distorted thinking" when they are NOT! Those are real concerns, especially if you were employed by the government in the past, had come from a higher socioeconomic status before you were physically disabled, had many friends that you've lost because you were no longer able to join in the activities you once enjoyed together, etc. It's not "negative emotionality" that is the problem; it's the lack of addressing those traumas (and they are NOT "little t" - which is a minimizing term), processing the grief and loss issues after remembering and mourning those traumas, and then learning how to realign your past dreams/goals with new dreams/goals.

For example, many Ts have infantilized me to the point of saying that I'd basically fail in college. They said this back in the early 2000s. They didn't even ask me about my military experiences; they looked at a short, then petite, and half-Asian person and thought that I was too frail or whatever for college; that I should succumb to disabled life. I bought into their lies and did whatever I could to heal. I got a little better, but I languished and eventually got worse in other areas - most notably my physical and intellectual health. I returned to college and earned all A's, got honors, and got a paper published. I left the infantilizing T's and sought others, this time through the VA - a place I had avoided because I was afraid of experiencing military sexual trauma again. My life before the military, if they were to take an accurate psychosocial history, revealed that I was resilient as a child, was able to graduate from the police reserve academy, and was able to work security - all prior to enlisting in the military. I may have had undetected dissociative issues, but I managed to do well - as did so many others with DID, such as Herschel Walker and Robert B. Oxnam (two males whose professional lives were only temporarily affected until they got proper treatment for DID). Most people sensationalize DID as something that had occurred in movies - primarily by females, but one last movie that depicted a male psychopath ("Split"). These media sensationalizations lead to bias in the therapy room. I'm sure the same has occurred with other diagnoses. Therapists need to respect the past lives of their clients, their intelligence, and their unmet goals; they need to see their clients' strengths - past, present, and future - and they need to promote the idea of a growth (not fixed) mindset, in order for them to readjust their goals in accordance with their disabilities' limitations. T's need to see potential in their clients, or at least believe their clients' potentials when clients present them.

For instance, I may never run again due to my injuries in service, and I may not be fit for clinical work, but I love research and have always done relatively well in math, statistics, and at administrative work (when I was able to work). I knew that I wasn't able to work in the field or on patrol as police, but I also knew that I wanted to do more desk-like analytical jobs for the government anyway. That dream hasn't changed, but my infantilizing T's try to undermine my dreams and skills that are far from grandiose when compared to my stellar grades and accomplishments recently and in the past in college. When I said that I studied psychology and minored in criminal justice, they would almost roll their eyes. One T had even said, "But you didn't attend an Ivy League like I did, and almost everyone gets A's." If that wasn't minimizing or undermining my accomplishments and demonstrating either countertransferrence or arrogance on the part of the T - then I don't know what was. That T was almost doing "attack therapy," which is a real thing! That was the worst therapy for me, and it crippled my self-esteem for a while. Aside from that, my past diagnosis of DID was not believed, and I am struggling to integrate the rest of my fractured self while being placated by well-meaning, undertrained newbie therapists who truly are trying every short-term treatment in the book and not looking at my long-term therapeutic needs. If short-term is all you can offer, than I will work with that, but know this - I have worked with that for over two decades now! And I'm not treatment-resistant in the way they think; I'm willing to try anything and see if it works, and some of it has, but the T needed to combine that one specialized treatment with another, or at least refer me to the next step. I've went over and over and over again the same treatments (mostly CBT involved), but that's not what I need. I need to speak about traumas without having the therapist get secondary trauma and then countertransferring with me. I need a therapist who believes in my potentials, and who doesn't try to compare themselves with me, like the lady who went to an Ivy League and looked down on me as if I were a sick little girl who needed constant help in life. I'm not a sick little girl; I'm a woman, and an independent woman at that!

There's so much I can say, but I've been emotionally hurt, emotionally abused, retraumatized, and even physically abused while in therapy. I've had some decent therapists, and I had a really awesome in-patient male therapist (best ever), but I've had some really abusive therapists (male and female). It's got to stop!

Several months ago I wrote frankly about therapy failure to the consultant who referred me to the last therapist and who saw me personally for 6 months while the therapist was on maternity leave. That was the title of the email. It was something I was trying to do within my limited area of possible influence. I can't make them hear, but if I don't speak they don't have that chance.

Below is the email exchange, except for some identifying information.

I don't take. . .hogwash . . .that much any more. Yes, I know it doesn't sound very nice to name it like that. If anybody has any suggestions for how I could have responded better and differently, please feel free to let me know.

Even though I was badly abused by my first therapist (resulting in a 1 year hospitalization), I still have hope for the profession. I can only speak for myself, but I'd be dead or permanently locked on a state hospital unit if it weren't for my psychiatrist and current (9 years) therapist. I'm much more open with my psychiatrist so anything I think about psychiatry and his and my relationship he already knows and we've worked through it. My therapist and I struggle with what direction my recovery should take and that does create conflict.

My biggest global concern is the power differential that exists between client/patient and provider. Their ability to cause us pain is far greater than any discomfort we could cause them. I think that makes them a bit complacent with their actions and words. A better respect for the power they hold is essential so they use it wisely. What do I mean by power? Anyone who has the authority to restrain and sedate me has power over me. Anyone who encourages attachment and doesn't respect the many forms attachment can play out has power.

Certainly, the system needs an overhaul but as the proverbial saying goes...don't throw the baby out with the bathwater.

@here today

You did well to communicate with your T and address all your concerns. I'm so sorry you struggled with all that!

Although your T gave you a very short response, your T also has rights to not self-incriminate, as much as we would love for them to admit their wrongdoing in writing. This doesn't mean that I agree with the T (I don't, and I'm quite upset that you were hurt in treatment, and I don't know you, but I've been where you are and am now in-between therapists; I'm no professional, not even a grad student yet, and in my mid-40s). This does mean that a T would likely not respond in the way we would like, just like our past abusers would never admit or self-incriminate. Their self-preservation adds insult to injury for people like us. But the point is that you were strong enough to face your T, send her your feelings, and even hear back. It's what you heard back that was more painful than your expressing your feelings; I recall having dealt with similar responses, almost scripted, and almost without merit. Perhaps your T really meant what he/she said, or perhaps it was a scripted response (and therefore less than honest, unless she/he is speaking on behalf of the institution for where she works).

Your T may or may not take what you said into consideration with his/her future clients, and your T may or may not change for the better. Your T may share this information with his/her own therapist to help that T improve on whatever he/she missed during your therapy sessions, but you likely will not be privy to that.

You mentioned somewhere that you were in or near your 70s. You still have a lot of life to live!!! Do not give up! You are not alone, and there are groups you can join, alternatives to psychotherapy, different modalities of treatment (e.g., more empathetic, more existential, more humanistic, more client-centered, more eclectic), etc.

Many of us are feeling the weight of bad therapy, iatrogenic effects, therapeutic abuse, therapeutic malpractice, misdiagnoses, therapeutic ruptures, countertransference, and even criminal physical/sexual abuse from perpetrating therapists. Like many perpetrators and society as a whole (according to Judith Herman's book, "Trauma and Recovery") it's easier to blame the victim than it is to blame the perpetrators, traumas, abuses, etc., or address the etiologies of such perpetration, traumas, abuses, etc. Why? Cognitive dissonance, legal fears, bystander effect, reputational loss fears, and many of the same fears us clients have already faced or are about to face from the hands of the very ones who also fear the same things. But therapists tend to blame the victim (or their victims) and, like perpetrators, make it about the victim's mental illness. Last time I checked, anyone could be a victim, regardless of their mental illness, behavioral problems, physiological problems, etc. And, most people with lack of capable guardianship (e.g., lack of social networks, lack of physical health/ability, lack of mental health/ability) are often targets of perpetrators, even if perpetrators don't intend on harming. Emotional/psychological abuse may not be considered unlawful or criminal, but such abuse does harm. In some cases, such abuse is unlawful (but not criminal), but it takes money that many victims don't have to hire lawyers, fight, etc.

There are websites that discuss therapy abuse, and they can offer tips on whether you have a good case for litigation, or for at least reporting what you had experienced to the local Board where your last T was licensed. If you plan on litigation, however, some of the sites will suggest a certain order for which you make a complaint.

But, such complaints can backfire and really affect our reputation as victims, clients of mental health, etc. Or, the process of complaining can be even more traumatic. It's something that perpetrators know, business persons know, etc. It's sad, and it's scary. But it is worth facing the fear sometimes. It's up to each person to decide what is best for them.

That aside, you can always seek IN-PERSON support outside of clinical settings, such as peer-led support groups, meet-in groups, meet-up groups, and local organizations that can help. This was suggested to me by a therapist at one of the therapy abuse websites online. Because therapy has now become a trigger and a trauma memory, it makes seeking therapy thereafter all the more harder. Therapists may not realize this because their lives are relatively stable - financially, socially, and career-wise. Their clients' lives are not as fortunate, and there is a huge difference. Empathizing with us might be difficult for T's who are prone to burnout, who were parentified in their pasts, who are prone to compassion fatigue, who were traumatized themselves in their past, who were once impoverished, etc. Such T's haven't worked out their own issues and therefore inadvertently harm their clients while also blaming their clients. It's a thing, and it should be covered in their training, but many persons I've known (peers, actually) who have went through such training and went on to be therapists themselves have rolled their eyes at such training without taking it seriously. Seeing how they are trained opened my eyes to realizing that (1) I'd suck at that field (good thing I'm self-aware to know my own limitations, LOL), and (2) other people should have been screened out of such programs. While I was never in such programs, I did research alongside those who were, and I can tell you, they are NOT being trained properly. Even the director of a psych program admitted that he had never heard of "iatrogenic effects" or "iatrogenic neurosis."

It's sad, but true.

You're not alone. Please, know that your life is important, and you have a lot of life to live. We here care, or at least I do, even though I don't know you. Please, keep trying.

@lillib - your two last posts here are some of the most comprehensive, thoughtful and positive messages I recall reading on this forum. I did not even have many similar experiences and yet relate very much to your thinking and way of synthesizing a lot of this. Many of the points you raise are relevant to various professions, areas of society and human nature, I think - a lot of this is way broader than what happens in the psychotherapy/mental health topic that we are discussing here. Thank you

@sheltiemom2007

You are so right! Although the profession can use a lot of help, we cannot just chuck it. It's hard for me to go without therapy from time to time, or to empathize with the therapist. The power differential is the hardest. And when we try, with our strengths, to take our power back, we are slapped with another (mis)diagnosis, or we are held back down verbally and emotionally, which is to say that our power had been taken from us once again, instead of using that power to build up our esteem, to heal, to identify and utilize our strengths, and to not see that every argument in opposition is indicative of how we act toward others, or how it represents narcissism in the toxic sense. Our strengths matter as much as our symptoms, and both can work together. The power differential makes it harder to heal when our power as clients are taken away, yet again.

I think the basic premise and structure virtually guarantees abuse and harm on a routine basis. We're talking about human nature here. Good luck legislating that away.

To significantly lessen the hazards seems you'd have to overhaul the whole model, but then it wouldn't work anymore. Therapy is about social hierarchy and the needs of therapists. The system works well for them and business is good.

In order for the therapist to maintain their dominant position and retain the client, they must:
withhold information
resist transparency
use obfuscating language
apply stigmatizing and debilitating labels
impose their will
appeal to fear
pretend to have the answers
put blame on victims

In short, most of the things clients complain about.

I think when you walk thru the door, you are tacitly agreeing to be at least subtly exploited. Obviously that doesn't always happen.

I am glad that you both have found help in the system and have had people who, it sounds like, have helped and cared about you. Yes, we all need that.

But I disagree that about the current system -- I do think we should chuck the current model of relationship-oriented psychotherapy.

I wish I had the words and writing skill to write more about why I believe that. I wish I could describe what I believe would be an improved system. Unfortunately I don't believe I do have that ability right now. And the kind of overhaul I believe is necessary needs the involvement of lots more people than me anyway.

Agree. But some of us, for some reason, could not see that at the time.

This whole thing about power differential is interesting... I personally never felt that way in relation to a therapist and its existence likely would have never even occurred to me if I'd only relied on my own experience and remained unaware of the literature and hundreds of therapy stories. The reason I say here it is interesting because a few Ts told me that probably part of the reason therapy did not do much for me was because I did not engage in the power differential dynamic and its "development". Yeah, I agree that, in some ways, I am immune to aspects of traditional psychotherapy (especially the psychodynamic kind) because of that, but isn't it also a pretty shady and manipulative statement from a therapist? Not that I feel ashamed about that sort of immunity (or avoidance, call it whatever) or would have wanted to be more receptive to it. A therapist could demonstrate some power via their competency and helpfulness, but that would not be "power over me" either, just something to acknowledge and be grateful for, if it happened.

The part where mental health providers have the authority to involuntarily hospitalize a client or send the police to them is a somewhat different question IMO - I can see that being necessary and life-saving in some cases, even if undesired momentarily. But even regarding that, for example I only saw private therapists and never gave them my home address or emergency contacts. Or, when I was in a relapse with my addiction, I would never go to session intoxicated. These decisions might create limits to treatment, but I still my choices. I am not averse to medical treatment but would rather go to a hospital myself, not to a psychotherapist, if in a state that is so serious.

I certainly believed the whole, "therapy is a safe place," marketing campaign.

Foolish.

Wished I knew then what I know now.

That is why it is soooo important to share our insights with others!

Thanks,
HD7970ghz

Yes, and from this discussion -- I think some sort of general relationship information and disclaimers need to be on the informed consents. Making clear that the client knows and understands that they can get hurt. This may seem obvious and absurd to some people, but to others it is not. It could also open up some interesting discussions, if the therapy was one that included discussion.

@Xynesthesia2

You raise an interesting point about being immune to the power differential.

I consider police who are treatment for their traumas - most often required by their department or after a police-involved shooting incident. They often hold positions of power, are less likely to be agreeable, are more likely to have traits of narcissism, and are more likely to have unsubstantiated trauma experiences that often go untold. Because they are used to being in a position of power, it is highly likely that the therapeutic setting would be no different to them; in other words, they are most likely immune to the power differential because they may continue to see themselves on equal footing with the therapist (ideal) or, conversely, in opposition to them so that they can get back to work and have a clean bill of health, so as to avoid stigma, job loss, career loss, reputation loss, and many of the things non-police-officers experience as well.

Aside from police, there are professional CEOs and other high executives who seek treatment for their many differing types of disabilities. Unlike police who undergo trauma but presumably do not have any other mental disabilities (e.g., they would be screened out and/or disqualified from duty if they had anything other than trauma experiences, or even unmanaged or severe PTSD would presumably make them unfit for duty), those in the civilian workforce who hold positions of power within their companies/institutions might also have some immunity with the power differential in treatment. Like police in positions of power, other civilian workers in positions of power may only seek treatment part-time and may negate to disclose all of their symptoms for fear of stigma, loss of career, loss of jobs/advancements, loss of reputation, etc.

The stigma of mental illness is continuously reinforced with unsubstantiated claims of discrimination (not that discrimination hasn't happened, but it is harder to prove and therefore substantiate), harsh ad hominem attacks (statements like "you're insane; you don't belong in this job" or "I'm better than you because I don't have a mental illness"), judgment, microaggressions (e.g., you seem "bipolar" or "OCD" today, which is often said in a joking manner), etc. Such reinforcements makes it harder for certain populations to seek treatment because of the true, rational, and viable consequences that may ensue from having a mental illness record, even if those records are presumably confidential. For populations working in or seeking work in police, clinical settings, medical facilities, or otherwise, job applications and background checks often screen for any mental illness disclosure, diagnosis, hospitalizations, etc. If you lie, you're disqualified. If you're honest, they claim that they take that into consideration, but you're often screened out, even if you demonstrate that you have maintained your disabilities and were successful in treatment. This type of ecological system affects the therapist-client dyad, and the power differential. The clients who have a sense of self and some power in society may not be forthcoming with their therapists, and therefore may not receive all the benefits that are offered in care. Perhaps they are high-functioning persons with depression, PTSD, DID, or otherwise, as I've read about in memoirs and blogs.

Now take the population of those young persons aspiring to maximize their potentials through careers such as social work, clinical psychology, medicine, government work, etc. Such populations may be young in nature, may have the aptitude for such training, but may lack the necessary treatments to maintain their mental disabilities. They may be afraid to disclose to a therapist all of their symptoms for fear that their dreams will be discounted or minimized, their misdiagnosis or diagnoses will go on record, their confidentiality will eventually get broken, their career attainment and goals will be hindered or barred, and their conditions from potential traumatic losses will worsen. Since the therapist holds the power to annotate and record observations from what we clients disclose, and to hold the power of breaking confidentiality legally in the future (not just while we are temporarily under their care), such a power differential continuously reinforces the stigma brought against those with mental illnesses, and therefore the discrimination that ensues (despite ADA and other laws that try to combat these phenomena).

When minority and/or young clients who do not hold degrees, certain empowering social statuses, or certain high-stakes jobs enter the therapy room, it would appear that therapists would consider that in their psychosocial history and mental status exams as means for assuming that such clients' potentials are limited, or that claims of having certain intellectual strengths are "grandiose," as opposed to realistic needs and wants for maximizing potentials, taking one's life back after having it stripped from them in the past, etc. The power is taken away again and again, but the need for addressing the power differential is then pathologized as narcissism, treatment-resistant, a difficult client, a personality disorder, or otherwise, as opposed to a genuine concern that their more affluent and/or academically astute counterparts have addressed directly or indirectly. This constant power differential is widespread, cultural, hierarchical, and ongoing. You don't often see this issue in treatment for physiological problems, but you do see this more often than not in psychiatric and psychological fields. This is problematic and highly systemic. The blame should not fall on individuals, even though there are cases where grandiosity, delusional beliefs and thinking, and unrealistic goal-making are problematic and need to be addressed, even if the power differential remains in such cases.

I believe that immunity to the power differential is something that hasn't been addressed much in the literature on the efficacy of psychotherapy or the relationships between therapists and clients. I believe that such immunity is something noteworthy to consider, as well as other areas affecting access to and trust in psychotherapy.

These are just my thoughts and reactions to what I'm reading. I've never heard of this before, but I thought what you said was really important and noteworthy. If you were a scientist, I'd say go for this as a study. If you are an advocate, I'd say go with this as a form of advocacy. This really was an interesting point you made!!!

It sounds like you are NOT someone what was susceptible to getting hurt in therapy? Kuddos to you, and I'm glad you can share your perspectives and points of view, the contrast helps, I think. There could be some interesting insights generally in the contrasts, I think, if anybody was interested. Other aspects for research -- IF anybody was interested.

This is an important point, I think:

Sounds like you are "immune" to socially-defined authority but not to authentic authority, that you have been able to assess yourself? Does that sound about right? Words seem difficult here. Yes, and power shared freely does seem like something to acknowledge and be grateful for. Very different from compliance and control. Hm. . .

On the other hand I disagree somewhat about the social power to involuntarily hospitalize people. I think society does have a legitimate interest in trying identify and prevent people who may be a danger to themselves or others from taking harmful action. But I know 2 people personally who were ordered and taken to crisis detention centers by incompetent therapists and whose lives were hurt as a result. 72 hours and they were released, but still. . . So I'm not so sure about giving that authority to just anybody who has a therapist's license.

My biggest problem is the whole notion of attachment. Therapists, most anyway, encourage and foster clients to become emotionally attached to them in treatment. Attachment is tricky business. I have no parents and no real family. I have also been severely abused, documents to prove it. Cultivate trust with me and dangle that "you matter to me and I care about you " carrot in front of my nose, and like a starved bunny I'm going to go for it every time.

I started therapy in 1990. I was 30. I truly believed and was encouraged to believe that my therapist was my in fact mom. She adopted me into her family, literally. That was like food to a starving person. I learned brutally it was make-believe. It's been a lot of years since those horrid days. I've learned a lot. However, my basic psychological make-up is first take years to trust (which therapists take as a challenge) and then in increments bond. Once I bond, it's a big deal. It's not a light switch. Decide to change the rules you promised me and I'm destroyed. I won't act out or be a "bad client". I'll just be a reinjured severely abused little girl, easily ignored.

My psychiatrist has never made a commitment to me he didn't keep. He's never promised me things he knew he couldn't deliver. If I stray from our boundaries he gently brings me back. I know I am totally safe with him. It took a lot of years and a lot of miscues between us, but we've got it nailed down now. Our 24th anniversary is next month.

I wish I could say I felt that way with my therapist. Promises made. Promises broken. I stay anyway. I'm 58 years old. I'm not looking for a mom anymore. Just someone who respects that I never had one and is very careful not to injure.

Hi Sheltiemom2007,

I am right there with you in the trenches about attachment exploitation in therapy! It is an absolutely dangerous power imbalance. Makes you wonder how the industry is still operating when you come to think of it!

Thanks,
HD7970ghz

Lillib - that was another awesome analysis of many sides of that topic. I don't have time to respond to it in depth now, just wanted to say that I definitely identify with different components of what you brought up. E.g. I am in a leadership position in my career, so am used to having certain kinds of influence and power. But I fought it a lot when I was younger - I turned down I don't even know how many opportunities for powerful positions and I still do, because my nature somehow is that I really don't tend to care for social status and don't like hierarchy much on any side or level. I accept these things now and do it in order to be able to do other things that I enjoy (e.g. research with a team, mentoring), but that's about it. But I've grown to enjoy certain aspects of leadership with time, the ability and opportunity to initiate and reinforce positive developments (regarding knowledge, technology and human potential). I am primarily a scientist and did not care for advocacy at all when younger but now enjoy the latter as well even though it is not my primary nature, I don't consider myself a humanist, idealist or something similar. I do find these topics about therapy harm very interesting though but I already have plenty of projects and this would not overlap much with any of them, it is also not of my interest enough to work on it professionally. My interests lie more in understanding the causes of mental disorders on an organic level and developing new treatments (more medical than social). There is also the other important factor you brought up - I would not want to compromise my work relationships and connections in the mental health field, my career that I value, with taking a position of debunking providers or a whole system seriously and publicly. Surely it is not very authentic of me, given that I have these opinions as well... it is a compromise I choose, I rather write about it here or talk with interested people privately in the 3D world. There are other issues of social equality and justice that I am passionate about and think I can actaully do some thing effectively using and growing my career and position in a positive way, rather than potentially collapsing it.

Here today - you have identified those two elements of my "immunity" very well, thank you. I'm glad that someone understands the motives so clearly in an intuitive way because I have been grossly misunderstood on this forum by some before, and wasn't even given a chance to discuss and clarify. That pissed me off but I let it go because, really, it does not have much importance to me. But I believe that the misunderstanding arises also due to how opinions are presented, especially different views and disagreements. I have thought about all this a lot before, what my motivation is to participate in discussions like this, because it is not coming from being hurt by therapy/therapists in any serious way myself. But I did see one T for a while who is a serious danger that way and, while he did not damage me, the experience and his behavior seriously angered me. Very easy to see how he could severely hurt vulnerable people and, I think, he is so self-absorbed, he is not aware of a lot of it at all. Of course there are also the very smart, strategical, "sociopath" types, but my ex-T is not one of those, I think... much more a severely insecure and emotionally volatile person himself, who preys on people even more vulnerable than him, people who buy his hypocritical attitudes. I write about that experience often on PC. A big part of the motive is exactly what you mentioned - so much discussion here about painful therapy experiences and vulnerability, and I do believe I am not very vulnerable that way, which likely protected me from the effects of that jerk therapist in the past. But it still made me very angry because of how my motives, behavior and reactions were twisted by him and how he projected his crap onto me, without even truly listening to my true perspectives and trying to understand someone independent of him and very different from him. I do think I have a strong sense of self that I can express quite clearly when I want, it is never pleasant when someone completely dismisses who I am and paints their own self (or contrived image) onto it. I think I would be a bad therapist myself for several reasons, one being that I doubt I would tolerate client transferences well.

On the topic of emphasizing this "immunity" as contrast - that's exactly what, I think, I tried in the past here on PC and still do sometimes - some people appreciate it, but it does trigger others negatively and I don't want to do that too much again, what would be the point. People said several times that PC is meant to be more for support than for unbiased discussion and debate (even though there is often a lot of implicit debate and competition going on). That we come here from many different backgrounds and levels of mental health and cannot expect to be understood correctly and converse as equals all the time. People don't always react well to contrasts even if it is presented as some kind of scientific or philosophical discussion, or perhaps especially if it is presented that way. Also not a good idea to derail a thread like this, I think.

One reason I mentioned it in this context is that I think it would be an interesting and possibly useful topic for further study or research. I don't think therapists, and possibly others, understand it very well. And if you're in a different mind-state, as I was, then it's not just a matter of being able to change my mind based on hearing another point of view, even when I think that point of view may be interesting.

Somewhat related, I think the whole topic of narcissism is very poorly developed and has instead been sensationalized something awful in the last decade or so. The concept of ego and its (healthy) develop has, in contrast, been largely absent from current popular articles written by psychologists and others. I understand that this is likely not in your field, but I believe that it's a topic that could be researched effectively by clinical psychologists, if they were into scientific research, which they largely aren't. 25 years ago when I was taking some graduate developmental psychology classes there was some interesting research going on then. And it may well have gotten better since that time -- but possibly the results have not made it into influencing the sesationalist, touchy-feeling types in the clinical field? Despite their view of themselves sometimes, I did not find that many of them had a scientific temperament or understood the exciting potential for learning new things by studying differences and contrasts.

Here's something from 30 years ago that might be looked at again by current psychologists.

Loevinger's stages of ego development - Wikipedia

Or, hopefully there is something better by now -- but it never got into anything my therapists ever talked with me about.

After dealing with my dissociated parts and feelings, and the trauma that resulted in them, my last therapist totally failed at helping me integrate them and grow the whole thing, so to speak. Probably, now that I reflect on it, because she was so stymied still herself in certain ways. But depending on a psychotherapy relationship and psychotherapeutic alliance to help with ego development -- I don't think that's a very good modality. I needed/need something more group/community oriented. There's me, embedded in a community of others. Where do I end and the others begin? What even IS a boundary. There's not anything very organized in mental health these days for that, and I think that's something that needs to change.